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低血糖糖尿病患者就诊于急诊的特征。

Characteristics of Hypoglycemic Diabetic Patients Visiting the Emergency Room.

机构信息

Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

College of Pharmacy, Sookmyung Women's University, Seoul, Republic of Korea.

出版信息

Cardiovasc Ther. 2020 Jul 20;2020:3612607. doi: 10.1155/2020/3612607. eCollection 2020.

Abstract

INTRODUCTION

Severe hypoglycemia can be life-threatening; therefore, it is important to identify the characteristics of the hypoglycemic patients. The aim of this study is to analyze the type and characteristics of diabetic patients with hypoglycemia who visited an emergency room.

METHODS

We included diabetic patients with hypoglycemia who visited the emergency room of St. Mary's Hospital in Seoul from January 2009 to August 2018 in the study. Hypo_S group patients visited the emergency room once whereas Hypo_M group patients visited twice or more. We also compared the incidence of cardiovascular disease between the groups within 5 years after hypoglycemia.

RESULTS

A total of 843 patients were included in this study, with a mean age of 71 ± 14 years and average glycated hemoglobin (HbA1c) level of 6.7 ± 1.4%. For patients with hypoglycemia, lower body mass index, lower HbA1c, shorter diabetes duration, and lower glomerular filtration rate have a statistically significant relationship with patient characteristics in the emergency room group (all < 0.001). Hypoglycemia symptoms were most frequently observed between 6:00 and 12:00 am ( < 0.001). Cardiovascular diseases within 5 years after discharge were more frequent in the Hypo_S group than in the Hypo_M group; however, there was no statistical significance. The frequency of aneurysms was significantly higher in patients with hypoglycemia than in other patients in the emergency room ( < 0.05).

CONCLUSION

Relatively thin older patients with a diabetes duration shorter than 10 years and good blood sugar control showed higher frequency of visits to the emergency room due to hypoglycemia. For these patients, medical staff should always be mindful of their susceptibility to hypoglycemia when prescribing insulin or OHA and educate them on the prevention of hypoglycemia.

摘要

介绍

严重低血糖可能危及生命;因此,确定低血糖患者的特征很重要。本研究旨在分析因低血糖而到急诊室就诊的糖尿病患者的类型和特征。

方法

我们纳入了 2009 年 1 月至 2018 年 8 月期间到首尔圣玛丽医院急诊室就诊的低血糖糖尿病患者。Hypo_S 组患者仅就诊 1 次,Hypo_M 组患者就诊 2 次或更多次。我们还比较了两组患者低血糖后 5 年内心血管疾病的发生率。

结果

本研究共纳入 843 例患者,平均年龄为 71 ± 14 岁,平均糖化血红蛋白(HbA1c)水平为 6.7 ± 1.4%。对于低血糖患者,较低的体重指数、较低的 HbA1c、较短的糖尿病病程和较低的肾小球滤过率与急诊室患者的特征有统计学显著关系(均<0.001)。低血糖症状最常发生在凌晨 6:00 至 12:00(<0.001)。出院后 5 年内心血管疾病在 Hypo_S 组比 Hypo_M 组更常见;然而,没有统计学意义。低血糖患者的动脉瘤发生率明显高于其他急诊室患者(<0.05)。

结论

相对较瘦的老年患者,糖尿病病程短于 10 年,血糖控制良好,因低血糖就诊的频率更高。对于这些患者,医务人员在开具胰岛素或 OHA 时应始终注意其低血糖易感性,并教育他们预防低血糖。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/deed/7399730/b3a92909c217/CDTP2020-3612607.001.jpg

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